pharmacology exam 5 nclex questions

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chapter 18
For the client taking epinephrine, the nurse realizes there is a possible drug interaction with which drug?
a. albuterol (Proventil)
b. metoprolol (Lopressor)
c. bethanechol (Urecholine)
d. tolterodine tartrate (Detrol)

b. metoprolol (Lopressor)

2.The nurse will monitor the client taking albuterol (Proventil) for which condition?

a. Palpitations
b. Hypoglycemia
c. Bronchospasm
d. Uterine contractions

a. Palpitations

3.A client is prescribed metoprolol (Lopressor) to treat hypertension. It is important for the nurse to monitor the client for which condition?
a. Bradycardia
b. Hypertension
c. Ankle edema
d. Decreased respirations

a. Bradycardia

4.Atenolol (Tenormin) is prescribed for a client. The nurse realizes that this drug is a beta-adrenergic blocker and that this drug classification is contraindicated for clients with which condition?
a. Hypothyroidism
b. Angina pectoris
c. Cardiogenic shock
d. Liver dysfunction

c. Cardiogenic shock

5.The nurse realizes that beta1 receptor stimulation is differentiated from beta2 stimulation in that stimulation of beta1 receptors leads to which condition?
a. Increased bronchodilation
b. Decreased uterine contractility
c. Increased myocardial contractility
d. Decreased blood flow to skeletal muscles

c. Increased myocardial contractility

6. A client is given epinephrine (Adrenalin), an adrenergic agonist (sympathomimetic). The nurse should monitor the client for which condition?
a. Decreased pulse
b. Pupil constriction
c. Bronchial constriction
d. Increased blood pressure

d. Increased blood pressure

7.The nurse is administering atenolol (Tenormin) to a client. Which concurrent drug does the nurse expect to most likely cause an interaction?
a. ginseng herb
b. An NSAID, such as aspirin
c. methyldopa (Aldomet)
d. haloperidol (Haldol)

b. An NSAID, such as aspirin

Chapter 19
1. A client is receiving bethanechol (Urecholine). The nurse realizes that the action of this drug is to treat:
a. Glaucoma
b. Urinary retention
c. Delayed gastric emptying
d. Gastroesophageal reflux disease

b. Urinary retention

2. The nurse teaches the client receiving atropine to expect which side effect?
a. Diarrhea
b. Bradycardia
c. Blurred vision
d. Frequent urination

c. Blurred vision

3. When benztropine (Cogentin) is ordered for a client, the nurse acknowledges that this drug is an effective treatment for which condition?
a. Parkinsonism
b. Paralytic ileus
c. Motion sickness
d. Urinary retention

a. Parkinsonism

4. Dicyclomine (Bentyl) is an anticholinergic, which the nurse realizes is given to treat which condition?
a. Mydriasis
b. Constipation
c. Urinary retention
d. Irritable bowel syndrome

d. Irritable bowel syndrome

5. The nurse realizes that cholinergic agonists mimic which parasympathetic neurotransmitter?
a. dopamine
b. acetylcholine
c. cholinesterase
d. monoamine oxidase

b. acetylcholine

6. The nurse is administering a cholinergic agonist and should know that the expected cholinergic effects include which of the following?
a. Increased heart rate
b. Decreased peristalsis
c. Decreased salivation
d. Increased pupil constriction

d. Increased pupil constriction

7. When the client has a cholinergic overdose, the nurse anticipates administration of which drug as the antidote?
a. atropine
b. bethanechol
c. ambenonium
d. metoclopramide

a. atropine

Chapter 20
1. When a 12-year-old child is prescribed methylphenidate, which is most important for the nurse to monitor?
a. The child's temperature
b. The child's respirations
c. The child's intake and output
d. The child's height and weight

d. The child's height and weight

2. Several children are admitted for diagnosis with possible attention deficit/hyperactivity disorder. Which is most important for the nurse to observe?
a. A girl who is lethargic
b. A girl who lacks impulsivity
c. A boy with smooth coordination
d. A boy with an inability to complete tasks

d. A boy with an inability to complete tasks

3. A client is taking benzphetamine. The nurse teaches the client which information about this drug?
a. That it may cause drowsiness
b. That it may lead to hypotension
c. That it is a respiratory stimulant
d. That it is safe during pregnancy



4. The nurse monitoring a client for methylphenidate withdrawal should observe the client for which condition?
a. Tremors
b. Insomnia

d. Tachycardia

3= b. That it may lead to hypotension



4= c. Weakness

5. The nurse teaches a client about which common side effect of analeptics?
a. Bradycardia
b. Constipation
c. Nervousness
d. Urinary retention

c. Nervousness

6. The nurse who is teaching the client to self-administer medications explains to the client that which drug treats narcolepsy?
a. modafinil
b. atomoxetine
c. lisdexamfetamine
d. methylphenidate

a. modafinil

7. A newborn client is in respiratory distress. The nurse anticipates preparation for which medication to be given?
a. modafinil
b. armodafinil
c. theophylline
d. amphetamine

c. theophylline

Chapter 21
1. It is important for the nurse teaching the client regarding secobarbital (Seconal) to include which information about secobarbital?
a. It is a short-acting drug that may cause one to awaken early in the morning.
b. It is an intermediate-acting drug that frequently causes REM rebound.
c. It is an intermediate-acting drug that frequently causes a hangover effect.
d. It is a long-acting drug that is frequently associated with dependence.

a. It is a short-acting drug that may cause one to awaken early in the morning.

2. A client taking lorazepam (Ativan) asks the nurse how this drug works. The nurse should respond by stating that it is a benzodiazepine that acts by which mechanism?
a. Depressing the central nervous system (CNS), leading to a loss of consciousness
b. Depressing the CNS, including the motor and sensory activities
c. Increasing the action of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) to GABA receptors
d. Creating an epidural block by placement of the local anesthetic in the outer covering of the spinal cord

c. Increasing the action of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) to GABA receptors

3. A client is taking zolpidem (Ambien) for insomnia. The nurse prepares a care plan that includes monitoring of the client for side effects/adverse reactions of this drug. Which is a side effect of zolpidem?
a. Insomnia
b. Headache
c. Laryngospasm
d. Blood dyscrasias

b. Headache

4. A client received spinal anesthesia. Which is most important for the nurse to monitor?
a. Loss of consciousness
b. Hangover effects and dependence
c. Hypotension and headaches
d. Excitement or delirium

c. Hypotension and headaches

5. A nurse is teaching a client about zolpidem. Which is important for the nurse to include in the teaching of this drug?
a. Maximum dose is 20 mg/d
b. May lead to psychological dependence
c. For older adults, dose is 15 mg at bedtime
d. Should only be used for 21 days or less

b. May lead to psychological dependence

6. A client is taking triazolam (Halcion). Which instructions about this drug are important for the nurse to include?
a. It may be used as a barbiturate for only 4 weeks.
b. Use as a nonbenzodiazepine to reduce anxiety.
c. This drug does not lead to vivid dreams or nightmares.
d. Avoid alcohol and smoking to prevent rebound insomnia.

d. Avoid alcohol and smoking to prevent rebound insomnia.

7. A client is to receive conscious sedation for a minor surgical procedure. Which drug administration should the nurse expect? (Select all that apply.)
a. Propofol (Diprivan) to sustain natural sleep
b. Lidocaine (Xylocaine) to provide local anesthesia
c. Midazolam (Versed) to promote sedation and following of commands
d. Ketamine (Ketalar) for rapid inductionand prolonged duration of action

a. Propofol (Diprivan) to sustain natural sleep
c. Midazolam (Versed) to promote sedation and following of commands

Chapter 22
1. The nurse witnesses a client's seizure involving generalized contraction of the body followed by jerkiness of arms and legs. The nurse reports that this is which type of seizure?
a. Myoclonic
b. Petit mal
c. Tonic clonic
d. Psychomotor

c. Tonic clonic

2. Phenytoin (Dilantin) has been prescribed for a client with seizures. The nurse should include which appropriate nursing intervention in the plan of care?
a. Reporting an abnormal phenytoin level of 18 mcg/mL
b. Monitoring CBC levels for early detection of blood dyscrasias
c. Encouraging the client to brush teeth vigorously to prevent plaque buildup
d. Teaching the client to stop the drug immediately when passing pinkish-red or reddish-brown urine

b. Monitoring CBC levels for early detection of blood dyscrasias

3. When administering phenytoin (Dilantin), the nurse realizes more teaching is needed if the client makes which statement?
a. "I must shake the oral suspension very well before pouring in the dose cup."
b. "I cannot drink alcoholic beverages when taking phenytoin."
c. "I should take phenytoin 1 hour before meals."
d. "I will need to get periodic dental checkups."

c. "I should take phenytoin 1 hour before meals."

4. A client is taking clonazepam (Klonopin) for absence (petit mal) seizures. Which value(s) should the nurse report as outside the therapeutic range for clonazepam? (Select all that apply.)
a. 5 mcg/mL
b. 15 mcg/mL
c. 60 ng/mL
d. 120 ng/mL

a. 5 mcg/mL
b. 15 mcg/mL
d. 120 ng/mL

5. A client is admitted to the emergency department with status epilepticus. Which drug should the nurse most likely prepare to administer to this client? (Select all that apply.)
a. diazepam (Valium)
b. midazolam (Versed)
c. gabapentin (Neurontin)
d. levetiracetam (Keppra)

a. diazepam (Valium)
b. midazolam (Versed)

6. The nurse should monitor the client receiving phenytoin (Dilantin) for which adverse effect?
a. Psychosis
b. Nosebleeds
c. Hypertension
d. Gum erosion

b. Nosebleeds

7. A client is taking valproic acid (Depakote). The nurse should monitor the client for a which therapeutic serum range?
a. 10 to 20 mcg/mL
b. 15 to 40 mcg/mL
c. 20 to 80 ng/mL
d. 40 to 100 mcg/mL

d. 40 to 100 mcg/mL

Chapter 23
1. A client with parkinsonism asks the nurse to explain what causes this condition. The most accurate response by the nurse is that parkinsonism is caused by the degeneration of which?
a. Cholinergic neurons
b. Dopaminergic neurons
c. Acetylcholine neurotransmitters
d. Monamine oxidase-B neurotransmitters

b. Dopaminergic neurons

2. A client is receiving carbidopa-levodopa for parkinsonism. What should the nurse know about this drug?
a. Carbidopa-levodopa may lead to hypertension.
b. Carbidopa-levodopa may lead to excessive saliva.
c. Dopaminergic and anticholinergic therapy may lead to drowsiness and sedation.
d. Dopaminergics and anticholinergics are contraindicated in clients with glaucoma.

d. Dopaminergics and anticholinergics are contraindicated in clients with glaucoma.

3. A family member of a client with Alzheimer's disease asks the nurse what causes this disorder. What does the nurse explain is the cause of Alzheimer's disease?
a. An excess of acetylcholine
b. Neurofibrillary tangles inside neurons
c. Degeneration of dopaminergic neurons
d. Neuritic plaques that form inside neurons in the cerebellum

b. Neurofibrillary tangles inside neurons

4. A client is taking rivastigmine (Exelon). The nurse should teach the client and family which information about rivastigmine?
a. That hepatotoxicity may occur
b. That the initial dose is 6 mg t.i.d
c. That GI distress is a common side effect
d. That weight gain may be a side effect

c. That GI distress is a common side effect

5. Nursing interventions for the client taking carbidopa-levodopa for parkinsonism include which?
a. Encouraging client to adhere to a high-protein diet
b. Informing client that perspiration may be dark and stain clothing
c. Advising client that glucose levels should be checked through urine testing
d. Warning client that it may take 4 to 5 days before symptoms are controlled

b. Informing client that perspiration may be dark and stain clothing

6. What should the client who is taking anticholinergic therapy for parkinsonism be taught? (Select all that apply.)
a. To avoid alcohol, cigarettes, and caffeine
b. To relieve dry mouth with hard candy or ice chips
c. To use sunglasses to reduce photophobia
d. To urinate 2 hours after taking the drug
e. To receive routine eye examinations

a. To avoid alcohol, cigarettes, and caffeine
b. To relieve dry mouth with hard candy or ice chips
c. To use sunglasses to reduce photophobia
e. To receive routine eye examinations

7. A client is taking tacrine (Cognex) to improve cognitive function. What should the nurse teach the client? (Select all that apply.)
a. That the client should rise slowly to avoid dizziness
b. That obstacles should be removed from pathways to avoid injury
c. That the drug dosing schedule should be followed closely
d. That the client should be checked frequently for hypertension
e. That the client should receive regular liver function tests

a. That the client should rise slowly to avoid dizziness
b. That obstacles should be removed from pathways to avoid injury
c. That the drug dosing schedule should be followed closely
e. That the client should receive regular liver function tests

Chapter 24
1. When the nurse explains the pathophysiology of myasthenia gravis to a client, which is the best explanation?
a. Degeneration of cholinergic neurons and a deficit in acetylcholine leads to neuritic plaques and neurofibrillary tangles.
b. Decreased amount of acetylcholine to cholinergic receptors produces weak muscles and reduced nerve impulses.
c. Myelin sheaths of nerve fibers in brain and spinal cord develop lesions or plaques.
d. Imbalance of dopamine and acetylcholine leads to degeneration of neurons in midbrain and extrapyramidal motor tracts.

b. Decreased amount of acetylcholine to cholinergic receptors produces weak muscles and reduced nerve impulses.

2. For the client receiving pyridostigmine administration, the nurse should monitor for which adverse reaction?
a. Hypertension
b. Bronchospasm
c. Thrombocytopenia
d. Stevens-Johnson syndrome

b. Bronchospasm

3. A client has spasticity following a spinal cord injury. The nurse should expect which drug to be prescribed to treat this client's spasticity?
a. Tacrine
b. Ropinirole
c. Carisoprodol
d. Pyridostigmine

c. Carisoprodol

4. A client with multiple sclerosis is in the chronic progressive phase. The nurse should expect which drug to be most helpful at this time?
a. Interferon β-1a (Avonex, Rebif)
b. Glucocorticoids
c. Azathioprine (Imuran)
d. Cyclophosphamide (Cytoxan)

d. Cyclophosphamide (Cytoxan)

5. A client is taking carisoprodol (Soma). Which statement would the nurse include in teaching the client about this drug?
a. It may cause hypertension.
b. It may lead to bradycardia.
c. It blocks interneuronal activity.
d. Its action is decreased by antihistamines.

c. It blocks interneuronal activity.

6. A client who is prescribed pyridostigmine bromide (Mestinon) is being taught about the drug. Which statements should the nurse include in the teaching? (Select all that apply.)
a. The drug must be taken on time.
b. The drug must be taken two times per day.
c. Underdosing can result in cholinergic crisis.
d. Overdosing can result in cholinergic crisis.
e. The client should report the adverse effects of tachycardia to the health care provider.

a. The drug must be taken on time.
c. Underdosing can result in cholinergic crisis.
d. Overdosing can result in cholinergic crisis.

7. A client is beginning to take carisoprodol (Soma). Which interventions should the nurse include in the care of this client? (Select all that apply.)
a. Ask the client if there is any history of narrow-angle glaucoma.
b. Inform the client that muscular pain is usually relieved within 1 week.
c. Tell the client to report dizziness and double vision to the health care provider.
d. Advise the client to avoid alcohol and other CNS depressants.
e. Instruct the client that this drug should not be stopped abruptly.

b. Inform the client that muscular pain is usually relieved within 1 week.
c. Tell the client to report dizziness and double vision to the health care provider.
d. Advise the client to avoid alcohol and other CNS depressants.
e. Instruct the client that this drug should not be stopped abruptly.

Chapter 26
1. The nurse knows that which medication will cause the least gastrointestinal distress?
a. aspirin
b. ketorolac
c. celecoxib
d. ibuprofen

c. celecoxib

2. A client states during a medical history that he takes several acetaminophen tablets throughout the day. The nurse teaches the client that the dosage should not exceed which amount?
a. 1 g/day
b. 2 g/day
c. 4 g/day
d. 6 g/day

c. 4 g/day

3. For the client receiving periodic morphine IV push, which is most critical for the nurse to monitor?
a. Fever
b. Diarrhea
c. Respirations
d. White blood cell count

c. Respirations

4. A client is admitted to the emergency department in respiratory depression following self-injection with hydromorphone. The admitting nurse knows that which drug will reverse respiratory depression caused by opioid overdose?
a. fentanyl
b. naloxone
c. butorphanol
d. sufenta

b. naloxone

5. Assessing a client following IV morphine administration, the nurse notes cold, clammy skin; a pulse of 40 beats/min; respirations of 10 breaths/min; and constricted pupils. Which medication will the client likely need next?
a. naloxone (Narcan)
b. meloxicam (Mobic)
c. pentazocine (Talwin)
d. propoxyphene (Darvon)

a. naloxone (Narcan)

6. For the client who is taking acetaminophen (Tylenol), what should the nurse do? (Select all that apply.)
a. Monitor routine liver enzyme tests.
b. Encourage the client to check package labels of OTC drugs to avoid overdosing.
c. Teach the diabetic client taking acetaminophen to check blood glucose more frequently.
d. Teach the female client that oral contraceptives can increase the effect of acetaminophen.
e. Teach the client that caffeine decreases the effects of acetaminophen.

a. Monitor routine liver enzyme tests.
b. Encourage the client to check package labels of OTC drugs to avoid overdosing.
c. Teach the diabetic client taking acetaminophen to check blood glucose more frequently.

7. For the client who is taking nalbuphine (Nubain), what should the nurse do? (Select all that apply.)
a. Monitor any changes in respirations.
b. Instruct the client to report bradycardia.
c. Administer IV nalbuphine undiluted.
d. Explain to the client to expect an excessive amount of urine output.
e. Instruct the client to avoid alcohol when taking nalbuphine to avoid respiratory depression.

a. Monitor any changes in respirations.
c. Administer IV nalbuphine undiluted.
e. Instruct the client to avoid alcohol when taking nalbuphine to avoid respiratory depression.

8. The nurse should know that which drugs are used to treat migraine attacks?
a. Triptans
b. Anticonvulsants
c. Tricyclic antidepressants
d. Beta-adrenergic blockers

a. Triptans

Chapter 27
1. The nurse realizes that facial grimacing, involuntary upward eye movement, and muscle spasms of the tongue and face are indicative of which condition?
a. Akathisia
b. Acute dystonia
c. Tardive dyskinesia
d. Pseudoparkinsonism

b. Acute dystonia

2. The nurse understands that antipsychotics act in which way?
a. By blocking actions of dopamine
b. By blocking actions of epinephrine
c. By promoting prostaglandin synthesis
d. By enhancing the action of gamma-aminobutyric acid

a. By blocking actions of dopamine

3. An antipsychotic agent, fluphenazine (Prolixin), is ordered for a client with psychosis. The nurse knows that this agent can lead to extrapyramidal symptoms (EPS) that may be treated with which medication?
a. quetiapine (Seroquel)
b. aripiprazole (Abilify)
c. benztropine (Cogentin)
d. chlorpromazine (Thorazine)

c. benztropine (Cogentin)

4. An atypical antipsychotic is prescribed for a client with psychosis. The nurse understands that this category of medications includes which drug?
a. clozapine (Clozaril)
b. loxapine (Loxitane)
c. haloperidol (Haldol)
d. thiothixene (Navane)

a. clozapine (Clozaril)

5. The nurse is aware of which fact regarding lorazepam (Ativan)?
a. It may cause confusion and blurred vision.
b. It has a maximum adult dose of 25 mg/day.
c. When combined with cimetidine, it causes plasma levels to be decreased.
d. It interferes with the binding of dopamine receptors.

a. It may cause confusion and blurred vision.

6. A client is receiving haloperidol (Haldol). Which nursing intervention(s) should the nurse perform? (Select all that apply.)
a. Monitor vital signs to detect bradycardia.
b. Remain with the client until medication is swallowed.
c. Monitor vital signs to detect orthostatic hypotension.
d. Assess the client for evidence of neuroleptic malignant syndrome.
e. Observe the client for acute dystonia, akathisia, and tardive dyskinesia.

b. Remain with the client until medication is swallowed.
c. Monitor vital signs to detect orthostatic hypotension.
d. Assess the client for evidence of neuroleptic malignant syndrome.
e. Observe the client for acute dystonia, akathisia, and tardive dyskinesia.

7. A client appears to have had an overdose of phenothiazines. The nurse is aware that the potential treatment for phenothiazine overdose includes which intervention(s)? (Select all that apply.)
a. Gastric lavage
b. Adequate hydration
c. Maintaining an airway
d. fluphenazine (Prolixin)
e. risperidone (Risperdal)
f. Activated charcoal administration

a. Gastric lavage
b. Adequate hydration
c. Maintaining an airway
f. Activated charcoal administration

Chapter 28
1. A client is admitted with bipolar affective disorder. The nurse acknowledges that which medication is used to treat this disorder for some clients in place of lithium?
a. thiopental
b. gingko biloba
c. fluvoxamine (Luvox)
d. divalproex (Depakote)

d. divalproex (Depakote)

2. The nurse realizes that some herbs interact with selective serotonin reuptake inhibitors (SSRIs). Which herb interaction may cause serotonin syndrome?
a. feverfew
b. ma-huang
c. St. John's wort
d. gingko biloba

c. St. John's wort

3. A selective serotonin reuptake inhibitor (SSRI) is prescribed for a client. The nurse knows that which drug is an SSRI?
a. paroxetine (Paxil)
b. amitriptyline (Elavil)
c. divalproex sodium (Depakote)
d. bupropion HCl (Wellbutrin)

a. paroxetine (Paxil)

4. A client is taking tranylcypromine sulfate (Parnate) for depression. What advice should the nurse include in the teaching plan for this medication?
a. Warn of severe hypotension.
b. Avoid beer and cheddar cheese.
c. Encourage ginseng and ephedra.
d. Encourage fruit such as bananas.

b. Avoid beer and cheddar cheese.

5. Which statement is true concerning lithium?
a. The maximum dose is 3.4 g/day.
b. The therapeutic drug range is 2.5 to 3.5 mEq/L.
c. Lithium increases receptor sensitivity to GABA.
d. Concurrent NSAIDs may increase lithium levels.

d. Concurrent NSAIDs may increase lithium levels.

6. When a client is taking an antidepressant, what should the nurse do? (Select all that apply.)
a. Monitor the client for suicidal tendencies.
b. Observe the client for orthostatic hypotension.
c. Teach the client to take the drug with food if GI distress occurs.
d. Tell the client that the drug may not have full effectiveness for 1 to 2 weeks.
e. Advise the client to maintain adequate fluid intake of 2 L/day.

a. Monitor the client for suicidal tendencies.
b. Observe the client for orthostatic hypotension.
c. Teach the client to take the drug with food if GI distress occurs.
d. Tell the client that the drug may not have full effectiveness for 1 to 2 weeks.

7. A client is taking lithium. The nurse should be aware of the importance of which nursing intervention(s)? (Select all that apply.)
a. Observe the client for motor tremors.
b. Monitor the client for orthostatic hypotension.
c. Draw lithium blood levels immediately after a dose.
d. Advise the client to drink 750 mL/day of fluid in hot weather.
e. Advise the client to avoid caffeinated foods and beverages, such as coffee, tea, colas, and chocolate.
f. Teach the client to take lithium with meals to decrease gastric irritation.

a. Observe the client for motor tremors.
b. Monitor the client for orthostatic hypotension.
e. Advise the client to avoid caffeinated foods and beverages, such as coffee, tea, colas, and chocolate.
f. Teach the client to take lithium with meals to decrease gastric irritation.

NCLEX book chapter 59
676. A client has a prescription to take guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will:
1. Take an extra dose if fever develops.
2. Take the medication with meals only.
3. Take the tablet with a full glass of water.
4. Decrease the amount of daily fluid intake.

3. Take the tablet with a full glass of water.

677. A nurse is preparing to administer a dose of naloxone hydrochloride (Narcan) intravenously to a client with an intravenous opioid overdose. Which supportive medical equipment would the nurse plan to have at the client's bedside if needed?
1. Nasogastric tube
2. Paracentesis tray
3. Resuscitation equipment
4. Central line insertion tray

3. Resuscitation equipment

678. A nurse teaches a client about the effects of diphenhydramine (Benadryl), which has been prescribed as a cough suppressant. The nurse determines that the client needs further instructions if the client states that he or she will:
1. Take the medication on an empty stomach.
2. Avoid using alcohol while taking this medication.
3. Use sugarless gum, candy, or oral rinses to decrease dry mouth.
4. Avoid activities requiring mental alertness while taking this medication.

1. Take the medication on an empty stomach.

679. A cromolyn sodium (Intal) inhaler is prescribed for a client with allergic asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells that client that which undesirable effect is associated with this medication?
1. Insomnia
2. Constipation
3. Hypotension
4. Bronchospasm

4. Bronchospasm

680. Terbutaline (Brethine) is prescribed for a client with bronchitis. A nurse understands that this medication should be used with caution if which of the following medical conditions is present in the client?
1. Osteoarthritis
2. Hypothyroidism
3. Diabetes mellitus
4. Polycystic disease

3. Diabetes mellitus

681. Zafirlukast (Accolate) is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication?
1. Platelet count
2. Neutrophil count
3. Liver function tests
4. Complete blood count

3. Liver function tests

682. A client has been taking isoniazid (INH) for 1½ months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing:
1. Hypercalcemia
2. Peripheral neuritis
3. Small blood vessel spasm
4. Impaired peripheral circulation

2. Peripheral neuritis

683. A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:
1. Use alcohol in small amounts only.
2. Report yellow eyes or skin immediately.
3. Increase intake of Swiss or aged cheeses.
4. Avoid vitamin supplements during therapy.

2. Report yellow eyes or skin immediately.

684. A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:
1. Should always be taken with food or antacids
2. Should be double-dosed if one dose is for-gotten
3. Causes orange discoloration of sweat, tears, urine, and feces
4. May be discontinued independently if symptoms are gone in 3 months

3. Causes orange discoloration of sweat, tears, urine, and feces

685. A nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states to report immediately:
1. Impaired sense of hearing
2. Gastrointestinal side effects
3. Orange-red discoloration of body secretions
4. Difficulty in discriminating the color red from green

4. Difficulty in discriminating the color red from green

686. A client with tuberculosis is being started on antituberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed?
1. Electrolyte levels
2. Liver enzyme levels
3. Serum creatinine level
4. Coagulation times

2. Liver enzyme levels

687. A nurse has an order to give a client salmeterol (Serevent Diskus), two puffs, and beclomethasone dipropionate (Qvar), two puffs, by metered-dose inhaler. The nurse administers the medication by giving the:
1. Beclomethasone first and then the salmeterol
2. Salmeterol first and then the beclomethasone
3. Alternating a single puff of each, beginning with the salmeterol
4. Alternating a single puff of each, beginning with the beclomethasone

2. Salmeterol first and then the beclomethasone

688. The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions?
1. "I must take the medication exactly as prescribed."
2. "Once I start the medication, I will no longer be contagious."
3. "I will not get any colds or infections while taking this medication."
4. "This medication has minimal side effects and I can return to normal activities."

1. "I must take the medication exactly as prescribed."

689. A client has begun therapy with theophylline (Theo-24). A nurse plans to teach the client to limit the intake of which of the following while taking this medication?
1. Coffee, cola, and chocolate
2. Oysters, lobster, and shrimp
3. Melons, oranges, and pineapple
4. Cottage cheese, cream cheese, and dairy creamers

1. Coffee, cola, and chocolate

690. The nurse has just administered the first dose of omalizumab (Xolair) to a client. Which statement by the client would alert the nurse that the client may be experiencing a life threatening adverse reaction?
1. "I have a severe headache."
2. "My feet are quite swollen."
3. "I am nauseated and may vomit."
4. "My lips and tongue are swollen."

4. "My lips and tongue are swollen."

691. Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which of the following side effects of the medication should the nurse monitor? Select all that apply.
1. Signs of hepatitis
2. Flu-like syndrome
3. Low neutrophil count
4. Vitamin B6 deficiency
5. Ocular pain or blurred vision
6. Tingling and numbness of the fingers

1. Signs of hepatitis
2. Flu-like syndrome
3. Low neutrophil count
5. Ocular pain or blurred vision

Chapter 61- cardio
717. A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. The nurse would determine that the client is receiving the therapeutic effect based on which of the following results?
1. Prothrombin time of 12.5 seconds
2. Activated partial thromboplastin time of 60 seconds
3. Activated partial thromboplastin time of 28 seconds
4. Activated partial thromboplastin time longer than 120 seconds

2. Activated partial thromboplastin time of 60 seconds

718. A nurse provides discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?
1. "I will take my pills every day at the same time."
2. "I will avoid alcohol consumption."
3. "I have already called my family to pick up a Medic-Alert bracelet."
4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."

4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."

719. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3 mEq/L and is complaining of anorexia. A physician prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?
1. 0.5 to 2 ng/mL
2. 1.2 to 2.8 ng/mL
3. 3 to 5 ng/mL
4. 3.5 to 5.5 ng/mL

1. 0.5 to 2 ng/mL

720. A client is being treated with procainamide (Procanbid) for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first?
1. Administer prescribed nitroglycerin tablets.
2. Measure the heart rate on the rhythm strip.
3. Obtain a 12-lead electrocardiogram immediately.
4. Auscultate the client's apical pulse and obtain a blood pressure.

4. Auscultate the client's apical pulse and obtain a blood pressure.

721. A nurse is monitoring a client who is taking propranolol (Inderal). Which assessment data would indicate a potential serious complication associated with propranolol?
1. The development of complaints of insomnia
2. The development of audible expiratory wheezes
3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
4. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication

2. The development of audible expiratory wheezes

722. A nurse is caring for a client receiving a heparin intravenous (IV) infusion. The nurse anticipates that which laboratory study will be prescribed to monitor the therapeutic effect of heparin?
1. Hematocrit
2. Hemoglobin
3. Prothrombin time
4. Activated partial thromboplastin time

4. Activated partial thromboplastin time

723. A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which of the following is a priority nursing intervention?
1. Monitor for renal failure.
2. Monitor psychosocial status.
3. Monitor for signs of bleeding.
4. Have heparin sodium available.

3. Monitor for signs of bleeding

724. A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy

3. Hypokalemia, hyperglycemia, sulfa allergy

725. A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education?
1. "Constipation and bloating might be a problem."
2. "I'll continue to watch my diet and reduce my fats."
3. "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store."

4. "I'll continue my nicotinic acid from the health food store."

726. A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions?
1. "It is not necessary to avoid the use of alcohol."
2. "The medication should be taken with meals to decrease flushing."
3. "Clay-colored stools are a common side effect and should not be of concern."
4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing."

4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing."

727. A 66-year-old client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include atenolol (Tenormin), digoxin (Lanoxin), and chlorothiazide (Diuril). A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
1. Dyspnea, edema, and palpitations
2. Chest pain, hypotension, and paresthesia
3. Double vision, loss of appetite, and nausea
4. Constipation, dry mouth, and sleep disorder

3. Double vision, loss of appetite, and nausea

728. A client is being treated for acute congestive heart failure with intravenously administered bumetanide (Bumex). The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the priority assessment?
1. Monitoring weight loss
2. Monitoring urine output
3. Monitoring blood pressure
4. Monitoring potassium level

3. Monitoring blood pressure

729. Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?
1. Protamine sulfate
2. Potassium chloride
3. Aminocaproic acid (Amicar)
4. Vitamin K (AquaMEPHYTON)

1. Protamine sulfate

730. A client is receiving thrombolytic therapy with a continuous infusion of streptokinase (Streptase). The client suddenly becomes extremely anxious and complains of itching. A nurse hears stridor and on examination of the client notes generalized urticaria and hypotension. Which of the following should be the priority action of the nurse?
1. Administer oxygen and protamine sulfate.
2. Stop the infusion and call the physician.
3. Cut the infusion rate in half and sit the client up in bed.
4. Administer diphenhydramine (Benadryl) and continue the infusion.

2. Stop the infusion and call the physician.

731. A client is admitted with pulmonary embolism and is to be treated with streptokinase (Streptase). A nurse would report which of the following assessments to the physician before initiating this therapy?
1. Adventitious breath sounds
2. Temperature of 99.4° F orally
3. Blood pressure of 198/110 mm Hg
4. Respiratory rate of 28 breaths/min

3. Blood pressure of 198/110 mm Hg

732. The nurse is monitoring a client who is taking digoxin (Lanoxin) for adverse effects. Which findings are characteristic of digoxin toxicity. Select all that apply.
1. Tremors
2. Diarrhea
3. Irritability
4. Blurred vision
5. Nausea and vomiting

2. Diarrhea
4. Blurred vision
5. Nausea and vomiting

chapter 67- neuro
816. Carbidopa-levodopa (Sinemet) is prescribed for the client with Parkinson's disease. The nurse monitors the client for side effects to the medication. Which of the following would indicate that the client is experiencing a side effect?
1. Pruritus
2. Tachycardia
3. Hypertension
4. Impaired voluntary movements

4. Impaired voluntary movements

817. The home health nurse visits a client who is taking phenytoin (Dilantin) for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse include in the teaching plan?
1. Pregnancy should be avoided while taking phenytoin.
2. The client may stop the medication if it is causing severe gastrointestinal effects.
3. There is the potential of decreased effectiveness of birth control pills while taking phenytoin.
4. There is the increased risk of thrombophlebitis while taking phenytoin and birth control pills together.

3. There is the potential of decreased effectiveness of birth control pills while taking phenytoin.

818. The nurse is caring for a client in the emergency department diagnosed with Bell's palsy. The client has been taking acetaminophen (Tylenol), and acetaminophen overdose is suspected. The nurse anticipates that the antidote to be prescribed is:
1. Pentostatin (Nipent)
2. Auranofin (Ridaura)
3. Fludarabine (Fludara)
4. Acetylcysteine (Mucomyst)

4. Acetylcysteine (Mucomyst)

819. The client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken daily for the relief of generalized discomfort. Which laboratory value would indicate toxicity associated with the medication?
1. Sodium level of 140 mEq/L
2. Prothrombin time of 12 seconds
3. Direct bilirubin level of 2 mg/dL
4. Platelet count of 400,000/mm3

3. Direct bilirubin level of 2 mg/dL

820. The client is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. Which of the following symptoms would be expected as a result of this laboratory result?
1. Hypotension
2. Tachycardia
3. Slurred speech
4. No symptoms, because this is a normal therapeutic level

3. Slurred speech

821. The client arrives at the emergency department complaining of back spasms. The client states, "I have been taking two to three aspirin every 4 hours for the last week, and it hasn't helped my back." Aspirin intoxication is suspected, and the nurse assesses the client for which of the following?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Photosensitivity

1. Tinnitus

822. A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol), 400 mg orally daily. Which of the following indicates that the client is experiencing a side effect to the medication?
1. Uric acid level, 5 mg/dL
2. Sodium level, 140 mEq/L
3. Blood urea nitrogen level, 15 mg/dL
4. White blood cell count, 3000/mm3

4. White blood cell count, 3000/mm3

823. The nurse is caring for a client with severe back pain. Codeine sulfate has been prescribed for the client. Which of the following does the nurse specifically include in the plan of care while the client is taking this medication?
1. Monitor fluid balance.
2. Monitor bowel activity.
3. Monitor peripheral pulses.
4. Monitor for hypertension.

2. Monitor bowel activity.

824. The nurse has given medication instructions to the client receiving phenytoin (Dilantin). The nurse determines that the client has an adequate understanding if the client states that:
1. "Alcohol is not contraindicated while taking this medication."
2. "Good oral hygiene is needed, including brushing and flossing."
3. "The medication dose may be self-adjusted, depending on side effects."
4. "The morning dose of the medication should be taken before a serum drug level is drawn."

2. "Good oral hygiene is needed, including brushing and flossing."

825. The client with myasthenia gravis has become increasingly weaker. The physician prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium (Tensilon) is administered. Which of the following would indicate that the client is in cholinergic crisis?
1. No change in the condition
2. Complaints of muscle spasms
3. An improvement of the weakness
4. A temporary worsening of the condition

4. A temporary worsening of the condition

826. Meperidine hydrochloride (Demerol) has been prescribed for a client to treat pain. Select the side effects of this medication. Select all that apply.
1. Diarrhea
2. Tremors
3. Drowsiness
4. Hypotension
5. Urinary frequency
6. Increased respiratory rate

2. Tremors
3. Drowsiness
4. Hypotension

chapter 77- psych
944. A client's medication sheet contains a prescription for sertraline (Zoloft). To ensure safe administration of the medication, a nurse would administer the dose:
1. On an empty stomach
2. At the same time each evening
3. Evenly spaced around the clock
4. As needed when the client complains of depression

2. At the same time each evening

945. A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). A nurse assesses the results of which laboratory study to monitor for adverse effects from this medication?
1. Platelet count
2. Blood glucose level
3. White blood cell count
4. Liver function studies

3. White blood cell count

946. A client is scheduled for discharge and will be taking phenobarbital (Luminal) for an extended period. A nurse would place highest priority on teaching the client which of the following points that directly relates to client safety?
1. Take the medication only with meals.
2. Take the medication at the same time each day.
3. Use a dose container to help prevent missed doses.
4. Avoid drinking alcohol while taking this medication.

4. Avoid drinking alcohol while taking this medication.

947. A nurse is describing the medication side effects to a client who is taking oxazepam (Serax). The nurse incorporates in discussions with the client the need to:
1. Consume a low-fiber diet.
2. Increase fluids and bulk in the diet.
3. Rest if the heart begins to beat rapidly.
4. Take antidiarrheal agents if diarrhea occurs.

2. Increase fluids and bulk in the diet.

948. A nurse is administering risperidone (Risperdal) to a client who is scheduled to be discharged. Before discharge, which of the following should the nurse teach the client?
1. Get adequate sunlight.
2. Avoid foods rich in potassium.
3. Continue driving as usual.
4. Get up slowly when changing positions.

4. Get up slowly when changing positions.

949. A nurse is teaching a client who is being started on imipramine (Tofranil) about the medication. The nurse informs the client that the maximum desired effects may:
1. Start during the first week of administration
2. Not occur for 2 to 3 weeks of administration
3. Start during the second week of administration
4. Not occur until after 2 months of administration

2. Not occur for 2 to 3 weeks of administration

950. A client receiving tricyclic antidepressants arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly?
1. Client reports not going to work for this past week.
2. Client arrives at the clinic neat and appropriate in appearance.
3. Client complains of not being able to "do anything" anymore.
4. Client reports sleeping 12 hours per night and 3 to 4 hours during the day.

2. Client arrives at the clinic neat and appropriate in appearance.

951. A nurse notes that a client with schizophrenia and receiving an antipsychotic medication is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing:
1. Parkinsonism
2. Tardive dyskinesia
3. Hypertensive crisis
4. Neuroleptic malignant syndrome

2. Tardive dyskinesia

952. A nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine (Prozac). What information would be important for the nurse to obtain during this client visit regarding the side effects of the medication?
1. Cardiovascular symptoms
2. Gastrointestinal dysfunctions
3. Problems with mouth dryness
4. Problems with excessive sweating

2. Gastrointestinal dysfunctions

953. A client who has been taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up assessment. A nurse determines that the medication is effective if the absence of which manifestation has occurred?
1. Paranoid thought process
2. Rapid heartbeat or anxiety
3. Alcohol withdrawal symptoms
4. Thought broadcasting or delusions

2. Rapid heartbeat or anxiety

954. A client taking lithium carbonate (Lithobid) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L. The nurse interprets this level as:
1. Toxic
2. Normal
3. Slightly above normal
4. Excessively below normal

1. Toxic

955. A home health nurse visits a client. The client gives the nurse a bottle of clomipramine (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. What behaviors observed in the client would validate noncompliance with this medication?
1. Complaints of insomnia
2. Complaints of hunger and fatigue
3. A pulse rate less than 60 beats/min
4. Frequent handwashing with hot soapy water

4. Frequent handwashing with hot soapy water

956. A hospitalized client has begun taking bupropion (Wellbutrin) as an antidepressant agent. A nurse monitors this client for which side effect indicating that the client is taking an excessive amount of medication?
1. Constipation
2. Seizure activity
3. Increased weight
4. Dizziness when getting upright

2. Seizure activity

957. A hospitalized client is started on phenelzine (Nardil) for the treatment of depression. A nurse instructs the client to avoid consuming which foods while taking this medication? Select all that apply.
1. Figs
2. Yogurt
3. Crackers
4. Aged cheese
5. Tossed salad
6. Oatmeal cookies

1. Figs
2. Yogurt
4. Aged cheese

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